Prostate CancerPhase 3NCT01193244
Study Comparing Orteronel Plus Prednisone in Participants With Chemotherapy-Naive Metastatic Castration-Resistant Prostate Cancer
A Phase 3 study testing Orteronel and Prednisone in people with Prostate Cancer, run by Millennium Pharmaceuticals, Inc. at 240 sites in 40 countries.
Trial summary
This is a randomized, double-blind, multicenter, phase 3 study evaluating orteronel (TAK-700) plus prednisone compared with placebo plus prednisone in the treatment of men with progressive, chemotherapy-naive, metastatic, castration-resistant prostate cancer (mCRPC) Read more about this study
- Who is it for?
- Ages 18 years and older, men only
- Conditions the study is for
- Prostate Cancer
- What is being tested?
- Orteronel and Prednisone
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,560 participants
- Where
- 240 sitesin 40 countries
- Study dates
- 1 Oct 2010to 7 Apr 2016
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Men only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Each patient must meet all of the following inclusion criteria:
- Voluntary written consent
- Male patients 18 years or older
- Histologically or cytologically confirmed diagnosis of prostate adenocarcinoma
- Radiograph-documented metastatic disease
- Progressive disease
Show all 12Show fewer
- Prior surgical castration or concurrent use of an agent for medical castration
- Either absence of pain or pain not requiring use of any opioid or narcotic analgesia in the 2 weeks prior to study entry
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Even if surgically sterilized, patients must practice effective barrier contraception during the entire study treatment and for 4 months after the last dose of study drug, OR abstain from heterosexual intercourse
- Meet screening laboratory values as specified in protocol
- Stable medical condition
Who cannot join
- Patients meeting any of the following exclusion criteria are not to be enrolled in the study:
- Known hypersensitivity to orteronel, prednisone or gonadotropin-releasing hormone (GnRH) analogue
- Received prior therapy with orteronel, aminoglutethimide, ketoconazole or abiraterone
- Received antiandrogen therapy within 6 weeks for bicalutamide and 4 weeks for all others prior to first dose of study drug
- Continuous daily use of oral prednisone or oral dexamethasone for more than 14 days within 3 months prior to study
- Received prior chemotherapy for prostate cancer with exception of neoadjuvant/adjuvant therapy as part of initial primary treatment for local disease that was completed 2 or more years prior to screening
Show all 16Show fewer
- Exposure to radioisotope therapy within 4 weeks of receiving first dose of study drug; exposure to external beam radiation within 2 weeks of start of screening until receiving the first dose of study drug
- Documented central nervous system metastases
- Treatment with any investigational compound within 30 days prior to first dose of study drug
- Current spinal cord compression, bilateral hydronephrosis or current bladder neck outlet obstruction
- Diagnosis or treatment of another malignancy within 2 years preceding first dose of study drug except nonmelanoma skin cancer or in situ malignancy completely resected
- Uncontrolled cardiovascular condition as specified in study protocol
- Known history of human immunodeficiency virus (HIV) infection, hepatitis B, or hepatitis C
- Unwilling or unable to comply with protocol
- Uncontrolled nausea, vomiting or diarrhea
- Known gastrointestinal disease or procedure that could interfere with oral absorption or tolerance of orteronel
Trial locations and contacts
240 sites in 40 countries.
240 sites in 40 countries
United States48 sites
Study site
Amarillo, Texas
Study site
Anchorage, Alaska
Study site
Aurora, Colorado
Study site
Baltimore, Maryland
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Bedford, Texas
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Boston, Massachusetts
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Charleston, South Carolina
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Chattanooga, Tennessee
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Columbia, Missouri
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Columbia, South Carolina
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Corinth, Mississippi
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Dallas, Texas
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Deerfield Beach, Florida
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Denton, Texas
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Denver, Colorado
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Duarte, California
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Duluth, Minnesota
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Durham, North Carolina
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East Syracuse, New York
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Fort Myers, Florida
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Hackensack, New Jersey
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Hershey, Pennsylvania
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Highland, California
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Jacksonville, Florida
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Jefferson City, Missouri
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Jeffersonville, Indiana
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Kansas City, Kansas
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Kettering, Ohio
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Lancaster, Pennsylvania
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Lansing, Michigan
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Las Vegas, Nevada
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Nashville, Tennessee
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New Orleans, Louisiana
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New York, New York
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Norfolk, Virginia
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Omaha, Nebraska
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Orange, California
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Orlando, Florida
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Philadelphia, Pennsylvania
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Piitsburgh, Pennsylvania
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Port Saint Lucie, Florida
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Raleigh, North Carolina
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Sacramento, California
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Salt Lake City, Utah
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San Francisco, California
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Tualatin, Oregon
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Tucson, Arizona
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Tyler, Texas
Brazil21 sites
Study site
Bairro Nazare - Salvador
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Barretos/sp
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Belo Horizonte
Study site
Campinas
Study site
Caxias do Sul
Study site
Curitiba
Study site
Fortaleza/ce
Study site
Ijuí
Study site
Joinville
Study site
Lajeado - Rs
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Piracicaba - Sp
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Porto Alegre- Rs
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Porto Alegre/rs
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Ribeirao Preto - Sp
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Rio de Janeiro
Study site
Rio de Janeiro Rj
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Santo André
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São José do Rio Preto
Study site
São José dos Campos
Study site
São Paulo
Study site
Sorocaba - Sp
Japan18 sites
Study site
Chiba
Study site
Fukuoka
Study site
Hamamatsu
Study site
Hokkaido
Study site
Kanazawa
Study site
Kita-gun
Study site
Maebashi
Study site
Mito
Study site
Osaka
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Sakura
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Sayama
Study site
Sendai
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Shimizucho Sunto-gun
Study site
Suntou-gun
Study site
Tokyo
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Yamagata
Study site
Yokohama
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Yufu
France13 sites
Study site
Angers
Study site
Bordeaux
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Caen
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Créteil
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La Roche-sur-Yon
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Lyon
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Marseille
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Nancy
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Nantes
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Paris
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Poitiers
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Saint-Etienne
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Villejuif
United Kingdom11 sites
Study site
Aberdeen
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Belfast
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Bristol
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Cottingham
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Coventry
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Glasgow
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London
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Manchester
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Northwood
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Preston
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Southampton
Canada10 sites
Study site
Burlington, Ontario
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Hamilton, Ontario
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Kelowna, British Columbia
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London, Ontario
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Montreal, Quebec
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Owen Sound, Ontario
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Pointe-Claire, Quebec
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Québec, Quebec
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Sherbrooke, Quebec
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Toronto, Ontario
Germany9 sites
Study site
Braunschweig
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Dresden
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Hamburg
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Hanover
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Kassel
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Kempen
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Nürtingen
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Tübingen
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Wuppertal
Netherlands8 sites
Study site
Amsterdam
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Arnhem
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Breda
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Eindhoven
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Heerlen
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Nieuwegein
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Nijmegen
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Rotterdam
Australia7 sites
Study site
Garran
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Hobart
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Kurralta Park
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Nedlands
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Perth
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Redcliffe
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Wodonga
Israel7 sites
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Haifa
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Holon
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Jerusalem
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Petah Tikva
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Ramat Gan
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Tel Aviv
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Tsrifin
Spain7 sites
Study site
A Coruña
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Barcelona
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Madrid
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Majadahonda
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Pamplona
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Seville
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Valencia
Belgium5 sites
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Edegem
Study site
Hasselt
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Kortrijk
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Leuven
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Namur
Greece5 sites
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Athens
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Heraklion Crete
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Larissa
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Pátrai
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Thessaloniki
New Zealand5 sites
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Auckland
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Christchurch
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Dunedin
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Takapuna
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Tauranga
Chile4 sites
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Las Condes
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Santiago
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Temuco
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Valparaíso
Finland4 sites
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Joensuu
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Oulu
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Seinäjoki
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Tampere
Slovakia4 sites
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Nitra
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Prešov
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Trenčín
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Žilina
South Africa4 sites
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Cape Town
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Durban
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George
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Port Elizabeth
Switzerland4 sites
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Aarau
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Lausanne
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Winterthur
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Zurich
Ukraine4 sites
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Dnipropetrovsk
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Donetsk
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Kyiv
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Zaporizhzhya
Mexico3 sites
Study site
Durango Durango
Study site
Mexico City Distrito Federal
Study site
Zapopan Jalisco
About this study
Official title: A Phase 3, Randomized, Double-Blind, Multicenter Trial Comparing Orteronel Plus Prednisone With Placebo Plus Prednisone in Patients With Chemotherapy-Naive Metastatic Castration-Resistant Prostate Cancer
This is a randomized, double-blind, multicenter, phase 3 study evaluating orteronel (TAK-700) plus prednisone compared with placebo plus prednisone in the treatment of men with progressive, chemotherapy-naive, metastatic, castration-resistant prostate cancer (mCRPC)
- Conditions
- Prostate Cancer
- Being tested
- Orteronel, Placebo, Prednisone
- Medical subject headings
- Prostatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
OrteronelDrug
Orteronel will be administered orally twice a day continuously throughout the study. Patients will also receive concomitant gonadotropin-releasing hormone (GnRH) analogue therapy unless they have previously undergone orchiectomy and have a testosterone concentration of <50 ng/dL.
PlaceboDrug
Placebo will be administered orally twice a day continuously throughout the study. Additionally, all patients will receive concomitant gonadotropin-releasing hormone (GnRH) analogue therapy unless they have previously undergone orchiectomy and a testosterone concentration of <50 ng/dL.
PrednisoneDrug
Prednisone will be administered orally twice a day continuously throughout the study. Patients will also receive concomitant gonadotropin-releasing hormone (GnRH) analogue therapy unless they have previously undergone orchiectomy and have a testosterone concentration of <50 ng/dL.
| Study group | Role | What they receive |
|---|---|---|
| Orteronel + prednisone | Experimental | Not described Receives: Drug: Orteronel; Drug: Prednisone |
| Placebo + prednisone | Placebo comparator | Not described Receives: Drug: Placebo; Drug: Prednisone |
What is being measured
The primary outcome is the main question the study is designed to answer.
Radiographic Progression-free Survival (rPFS)
rPFS was defined as the time from randomization to the first objective evidence of radiographic disease progression assessed by independent central radiology review or death due to any cause, whichever occurred first. Radiographic disease progression was evaluated by computerized tomography (CT) scan or magnetic resonance imaging (MRI) and radionuclide bone scans at regularly scheduled visits. Radiographic disease progression in bone required a confirmatory scan. Radiographic disease progression in soft tissue did not require a confirmatory scan for purposes of analysis. Radiographic disease progression was evaluated by independent central radiology review using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 for soft tissue disease and Prostate Cancer Working Group (PCWG2) guidelines for bone disease. Participants who did not reach the endpoint were censored at their last assessment.
Measured: Baseline until radiographic disease progression or death, whichever occurred first (approximately up to 4.7 years)
Overall Survival
Overall survival was calculated from the date of participant randomization to the date of participant death due to any cause. Participants without documentation of death at time of the analysis were censored as of the date the participant was last known to be alive, or the data cutoff date, whichever was earlier.
Measured: Baseline until death (up to 4.7 years)
Secondary outcomes (21)
Percentage of Participants Achieving 50 Percent Reduction From Baseline in Prostate Specific Antigen (PSA50) Response at Week 12
The PSA50 is defined as a decline of at least 50 percent (%) from baseline.
Measured: Week 12
Percentage of Participants With Favorable Circulating Tumor Cell Count (CTC) Levels at Week 12
A favorable CTC count was defined as less than <5 counts per 7.5 milliliter (mL) in whole blood. An unfavorable CTC count was defined as greater than or equal to (>=) 5 counts/7.5 mL in whole blood.
Measured: Week 12
Time to Pain Progression
Time to pain progression was defined as the time from participant randomization to the first assessment date of pain progression. Pain progression was defined as the occurrence of 1 of the following and confirmed by an additional assessment, at least 3 weeks but not more than 5 weeks later: The brief pain inventory-short form (BPI-SF) worst pain score was >=4 with a >=2 point increase over baseline in BPI-SF worst pain score with stable or increased analgesic use; The BPI-SF worst pain score was >=4 but not less than baseline with new or increased (relative to baseline) Step II or Step III analgesic use; The BPI-SF worst pain score was <=3 but not less than baseline with new or increased (relative to baseline) Step III analgesic use. BPI-SF was an 11-item questionnaire, designed to assess severity and impact of pain on daily functions. Total score ranged from 0 to 100 with lower scores being indicative of less pain or pain interference.
Measured: Baseline until End of treatment (EOT) (approximately up to 4.7 years)
Number of Participants Reporting One or More Treatment-emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
Measured: Baseline up to 30 days after last dose of study drug (Cycle 61 Day 58)
Number of Participants With Treatment-emergent Adverse Events Greater Than or Equal to (>=) Grade 3
Grade 3 (Severe) events=unacceptable or intolerable events, significantly interrupting usual daily activity, require systemic drug therapy/other treatment. Grade 4 (Life-threatening) events caused participant to be in imminent danger of death. Grade 5 (Death) events=death related to an AE.
Measured: Baseline up to 30 days after last dose of study drug (Cycle 61 Day 58)
Number of Participants With TEAEs Related to Vital Signs
Measured: Baseline up to 30 days after last dose of study drug (Cycle 61 Day 58)
Number of Participants With TEAEs Related to Weight
Measured: Baseline up to 30 days after last dose of study drug (Cycle 61 Day 58)
Number of Participants With Worst Change From Baseline in Eastern Co-operative Oncology Group (ECOG) Performance Status
ECOG assessed participant's performance status on 5 point scale: 0=Fully active/able to carry on all pre-disease activities without restriction; 1=restricted in physically strenuous activity, ambulatory/able to carry out light or sedentary work; 2=ambulatory (>50 percent of waking hours [hrs]), capable of all self care, unable to carry out any work activities; 3=capable of only limited self care, confined to bed/chair >50 percent of waking hrs; 4=completely disabled, cannot carry on any self care, totally confined to bed/chair; 5=dead. Worst change was defined as the worst overall change that occurred in ECOG status at any measured time point during the treatment period.
Measured: Baseline until EOT (approximately up to 4.7 years)
Number of Participants With Abnormal Clinically Significant Electrocardiogram (ECG) Findings
Measured: Baseline up to EOT (Cycle 61 Day 58)
Worst Change From Baseline Over Time in Cardiac Ejection Fraction
Worst change was defined as the worst overall change that occurred in cardiac ejection fraction at any measured time point.
Measured: Baseline up to 30 days or EOT whichever is later (approximately up to Cycle 61 Day 58)
Number of Participants With TEAEs Categorized Into Investigations Related to Chemistry, Hematology or Coagulation
Measured: Baseline up to 30 days or EOT whichever is later (approximately up to Cycle 61 Day 58)
Percentage of Participants With Skeletal Related Events (SRE)
Skeletal related (SRE) event is defined as a fracture or spinal cord compression or the need for radiation or surgery at the site of a prostate cancer metastatic lesion that is substantiated by radiographic or pathologic evidence.
Measured: Baseline up to EOT (approximately up to 4.7 years)
Time to SRE
Time to SRE is defined as the time from randomization to SRE, or death due to any cause, whichever comes first. SRE is defined as a fracture or spinal cord compression or the need for radiation or surgery at the site of a prostate cancer metastatic lesion that is substantiated by radiographic or pathologic evidence.
Measured: Baseline up to EOT (Cycle 61 Day 58)
Percentage of Participants Achieving PSA50 Response at Any Time During the Study
The PSA50 is defined as a decline of PSA by 50 percent from baseline.
Measured: Cycle: 4, 7, 10, 13, 16, 19, 22, 25, 28, 31, 34 and 37
Percentage of Participants Achieving 90 Percent Reduction From Baseline in Prostate Specific Antigen (PSA90 Response) at Week 12
The PSA90 is defined as a decline of PSA by 90 percent from baseline.
Measured: Week 12
Percentage of Participants Achieving PSA90 Response at Any Time During the Study
The PSA90 is defined as a decline of PSA by 90 percent from baseline.
Measured: Cycle: 4, 7, 10, 13, 16, 19, 22, 25, 28, 31, 34 and 37
Time to PSA Progression
Time to PSA progression was defined as time from randomization to a PSA increase of 25 percent and PSA rise of at least 2 nanogram per milliliter (ng/mL) above the lowest value observed post baseline or, if no PSA decline occurred post baseline, compared to baseline PSA.
Measured: Baseline until the final on treatment assessment or until end of short term follow-up following discontinuation of treatment, whichever occurred later (approximately up to 4.7 years)
Time to Docetaxel Chemotherapy
Time to docetaxel based chemotherapy is defined as the time from randomization to the start of docetaxel based chemotherapy for prostate cancer, regardless of whether the participant received concurrent orteronel or not. Deaths due to disease progression prior to Docetaxel based chemotherapy were considered as events.
Measured: Baseline until start of docetaxel chemotherapy (up to 4.7 years)
Time to Subsequent Antineoplastic Therapy
Time to subsequent antineoplastic therapy is defined as the time from randomization to the start of any alternate antineoplastic therapy for prostate cancer. Deaths due to disease progression prior to antineoplastic therapy for prostate cancer are considered as events. Otherwise, time to next therapy is censored at the date of death or the last date the participant was known to be alive or the data cutoff date, whichever is earlier.
Measured: Baseline until start of subsequent antineoplastic therapy (up to 4.7 years)
Percentage of Participants With Objective Response
Percentage of participants with objective response based assessment of confirmed complete response (CR) or confirmed partial response (PR) according to RECIST 1.1. A CR was defined as the disappearance of all target lesions determined by computerized tomography (CT) or MRI. Any pathological lymph nodes (whether target or non-target) must have had reduction in short axis to <10 millimetre (mm). A PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of longest diameters of non-lymph node lesions and of the short diameter or short axis of lymph nodes.
Measured: Baseline until disease progression or death, whichever occurred first (approximately up to 4.7 years)
Time to Deterioration in Global Health Status
Global health status deterioration is defined as a drop greater than 16 points from the baseline assessment, confirmed at least 3 weeks later, on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core Module 30 (EORTC QLQ-C30) index after the score has been linearly transformed to a 0 to 100 scale. EORTC QLQ-C30 consists of 30 questions, where question 1 to 28 can be answered with 1: Not at all, 2: A little, 3: Quite a bit, 4: Very much and question 29 to 30 with 1: Very poor to 7: Excellent. For subscales a high score from 0-100 indicates: high global quality of life, high level of functioning (physical, role, emotional, cognitive, social) or a high level of symptoms (fatigue, nausea, pain, dyspnea, insomnia, appetite loss, constipation, diarrhoea, financial difficulties).
Measured: Baseline until EOT (approximately up to 4.7 years)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Sep 2010 (estimated)
- Study start1 Oct 2010
- Primary completion1 Jan 2014
- Study completion7 Apr 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Prostate CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 1,560 participants (actual)
Sponsor and investigators
- Lead sponsor
- Millennium Pharmaceuticals, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Monitor, Study director, Millennium Pharmaceuticals, Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01193244
- Sponsor's protocol ID
- C21004
- Other IDs
- 2010-018661-35, 0991413276, 10/H0406/75, U1111-1181-0387
- Status last verified
- Apr 2017
- First submitted
- 31 Aug 2010
- Last updated
- 17 May 2017
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
Publications
Heller G, McCormack R, Kheoh T, Molina A, Smith MR, Dreicer R, Saad F, de Wit R, Aftab DT, Hirmand M, Limon A, Fizazi K, Fleisher M, de Bono JS, Scher HI. Circulating Tumor Cell Number as a Response Measure of Prolonged Survival for Metastatic Castration-Resistant Prostate Cancer: A Comparison With Prostate-Specific Antigen Across Five Randomized Phase III Clinical Trials. J Clin Oncol. 2018 Feb 20;36(6):572-580. doi: 10.1200/JCO.2017.75.2998. Epub 2017 Dec 22.
PubMed 29272162Suri A, Chapel S, Lu C, Venkatakrishnan K. Physiologically based and population PK modeling in optimizing drug development: A predict-learn-confirm analysis. Clin Pharmacol Ther. 2015 Sep;98(3):336-44. doi: 10.1002/cpt.155. Epub 2015 Jul 14.
PubMed 26031410Saad F, Fizazi K, Jinga V, Efstathiou E, Fong PC, Hart LL, Jones R, McDermott R, Wirth M, Suzuki K, MacLean DB, Wang L, Akaza H, Nelson J, Scher HI, Dreicer R, Webb IJ, de Wit R; ELM-PC 4 investigators. Orteronel plus prednisone in patients with chemotherapy-naive metastatic castration-resistant prostate cancer (ELM-PC 4): a double-blind, multicentre, phase 3, randomised, placebo-controlled trial. Lancet Oncol. 2015 Mar;16(3):338-48. doi: 10.1016/S1470-2045(15)70027-6. Epub 2015 Feb 18.
PubMed 25701170
Study at a glance
From the registry record, last updated by the sponsor on 17 May 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Randomized, Double-Blind, Multicenter Trial Comparing Orteronel Plus Prednisone With Placebo Plus Prednisone in Patients With Chemotherapy-Naive Metastatic Castration-Resistant Prostate Cancer
- ClinicalTrials.gov ID
- NCT01193244
- Acronym / sponsor ID
- C21004
- Conditions
- Prostate Cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,560 participants (actual)
- Lead sponsor
- Millennium Pharmaceuticals, Inc.Industry (pharma, biotech, devices)
- Study start
- 1 Oct 2010 (actual)
- Primary completion
- 1 Jan 2014 (actual)
- Study completion
- 7 Apr 2016 (actual)
- First posted
- 1 Sep 2010 (estimated)
- Results
- Posted 17 May 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a randomized, double-blind, multicenter, phase 3 study evaluating orteronel (TAK-700) plus prednisone compared with placebo plus prednisone in the treatment of men with progressive, chemotherapy-naive, metastatic, castration-resistant prostate cancer (mCRPC)
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Orteronel + prednisone | Experimental | Drug: Orteronel, Drug: Prednisone |
| Placebo + prednisone | Placebo comparator | Drug: Placebo, Drug: Prednisone |
Who may qualify
- Ages
- 18 years and older
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (12 listed)
- Voluntary written consent
- Male patients 18 years or older
- Histologically or cytologically confirmed diagnosis of prostate adenocarcinoma
- Radiograph-documented metastatic disease
- Progressive disease
Key exclusion criteria (16 listed)
- Patients meeting any of the following exclusion criteria are not to be enrolled in the study:
- Known hypersensitivity to orteronel, prednisone or gonadotropin-releasing hormone (GnRH) analogue
- Received prior therapy with orteronel, aminoglutethimide, ketoconazole or abiraterone
- Received antiandrogen therapy within 6 weeks for bicalutamide and 4 weeks for all others prior to first dose of study drug
- Continuous daily use of oral prednisone or oral dexamethasone for more than 14 days within 3 months prior to study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| OrteronelOrteronel will be administered orally twice a day continuously throughout the study. Patients will also receive concomitant gonadotropin-releasing hormone (GnRH) analogue therapy unless they have previously undergone orchiectomy and have a testosterone concentration of <50 ng/dL. | Drug | Orteronel + prednisone |
| PlaceboPlacebo will be administered orally twice a day continuously throughout the study. Additionally, all patients will receive concomitant gonadotropin-releasing hormone (GnRH) analogue therapy unless they have previously undergone orchiectomy and a testosterone concentration of <50 ng/dL. | Drug | Placebo + prednisone |
| PrednisonePrednisone will be administered orally twice a day continuously throughout the study. Patients will also receive concomitant gonadotropin-releasing hormone (GnRH) analogue therapy unless they have previously undergone orchiectomy and have a testosterone concentration of <50 ng/dL. | Drug | Orteronel + prednisone, Placebo + prednisone |
Primary outcome
Radiographic Progression-free Survival (rPFS)
Time frame: Baseline until radiographic disease progression or death, whichever occurred first (approximately up to 4.7 years)
rPFS was defined as the time from randomization to the first objective evidence of radiographic disease progression assessed by independent central radiology review or death due to any cause, whichever occurred first. Radiographic disease progression was evaluated by computerized tomography (CT) scan or magnetic resonance imaging (MRI) and radionuclide bone scans at regularly scheduled visits. Radiographic disease progression in bone required a confirmatory scan. Radiographic disease progression in soft tissue did not require a confirmatory scan for purposes of analysis. Radiographic disease progression was evaluated by independent central radiology review using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 for soft tissue disease and Prostate Cancer Working Group (PCWG2) guidelines for bone disease. Participants who did not reach the endpoint were censored at their last assessment.
Overall Survival
Time frame: Baseline until death (up to 4.7 years)
Overall survival was calculated from the date of participant randomization to the date of participant death due to any cause. Participants without documentation of death at time of the analysis were censored as of the date the participant was last known to be alive, or the data cutoff date, whichever was earlier.
21 secondary outcomes
Percentage of Participants Achieving 50 Percent Reduction From Baseline in Prostate Specific Antigen (PSA50) Response at Week 12
Time frame: Week 12
Percentage of Participants With Favorable Circulating Tumor Cell Count (CTC) Levels at Week 12
Time frame: Week 12
Time to Pain Progression
Time frame: Baseline until End of treatment (EOT) (approximately up to 4.7 years)
Number of Participants Reporting One or More Treatment-emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
Time frame: Baseline up to 30 days after last dose of study drug (Cycle 61 Day 58)
Number of Participants With Treatment-emergent Adverse Events Greater Than or Equal to (>=) Grade 3
Time frame: Baseline up to 30 days after last dose of study drug (Cycle 61 Day 58)
Number of Participants With TEAEs Related to Vital Signs
Time frame: Baseline up to 30 days after last dose of study drug (Cycle 61 Day 58)
Number of Participants With TEAEs Related to Weight
Time frame: Baseline up to 30 days after last dose of study drug (Cycle 61 Day 58)
Number of Participants With Worst Change From Baseline in Eastern Co-operative Oncology Group (ECOG) Performance Status
Time frame: Baseline until EOT (approximately up to 4.7 years)
Number of Participants With Abnormal Clinically Significant Electrocardiogram (ECG) Findings
Time frame: Baseline up to EOT (Cycle 61 Day 58)
Worst Change From Baseline Over Time in Cardiac Ejection Fraction
Time frame: Baseline up to 30 days or EOT whichever is later (approximately up to Cycle 61 Day 58)
Number of Participants With TEAEs Categorized Into Investigations Related to Chemistry, Hematology or Coagulation
Time frame: Baseline up to 30 days or EOT whichever is later (approximately up to Cycle 61 Day 58)
Percentage of Participants With Skeletal Related Events (SRE)
Time frame: Baseline up to EOT (approximately up to 4.7 years)
Time to SRE
Time frame: Baseline up to EOT (Cycle 61 Day 58)
Percentage of Participants Achieving PSA50 Response at Any Time During the Study
Time frame: Cycle: 4, 7, 10, 13, 16, 19, 22, 25, 28, 31, 34 and 37
Percentage of Participants Achieving 90 Percent Reduction From Baseline in Prostate Specific Antigen (PSA90 Response) at Week 12
Time frame: Week 12
Percentage of Participants Achieving PSA90 Response at Any Time During the Study
Time frame: Cycle: 4, 7, 10, 13, 16, 19, 22, 25, 28, 31, 34 and 37
Time to PSA Progression
Time frame: Baseline until the final on treatment assessment or until end of short term follow-up following discontinuation of treatment, whichever occurred later (approximately up to 4.7 years)
Time to Docetaxel Chemotherapy
Time frame: Baseline until start of docetaxel chemotherapy (up to 4.7 years)
Time to Subsequent Antineoplastic Therapy
Time frame: Baseline until start of subsequent antineoplastic therapy (up to 4.7 years)
Percentage of Participants With Objective Response
Time frame: Baseline until disease progression or death, whichever occurred first (approximately up to 4.7 years)
Time to Deterioration in Global Health Status
Time frame: Baseline until EOT (approximately up to 4.7 years)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 May 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 29272162Heller G, McCormack R, Kheoh T, Molina A, Smith MR, Dreicer R, Saad F, de Wit R, Aftab DT, Hirmand M, Limon A, Fizazi K, Fleisher M, de Bono JS, Scher HI. Circulating Tumor Cell Number as a Response Measure of Prolonged Survival for Metastatic Castration-Resistant Prostate Cancer: A Comparison With Prostate-Specific Antigen Across Five Randomized Phase III Clinical Trials. J Clin Oncol. 2018 Feb 20;36(6):572-580. doi: 10.1200/JCO.2017.75.2998. Epub 2017 Dec 22.
- Derived from this study: PubMed 26031410Suri A, Chapel S, Lu C, Venkatakrishnan K. Physiologically based and population PK modeling in optimizing drug development: A predict-learn-confirm analysis. Clin Pharmacol Ther. 2015 Sep;98(3):336-44. doi: 10.1002/cpt.155. Epub 2015 Jul 14.
- Derived from this study: PubMed 25701170Saad F, Fizazi K, Jinga V, Efstathiou E, Fong PC, Hart LL, Jones R, McDermott R, Wirth M, Suzuki K, MacLean DB, Wang L, Akaza H, Nelson J, Scher HI, Dreicer R, Webb IJ, de Wit R; ELM-PC 4 investigators. Orteronel plus prednisone in patients with chemotherapy-naive metastatic castration-resistant prostate cancer (ELM-PC 4): a double-blind, multicentre, phase 3, randomised, placebo-controlled trial. Lancet Oncol. 2015 Mar;16(3):338-48. doi: 10.1016/S1470-2045(15)70027-6. Epub 2015 Feb 18.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Monitor study director
Millennium Pharmaceuticals, Inc.
240 sites in 40 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Orteronel and Prednisone in people with Prostate Cancer, run by Millennium Pharmaceuticals, Inc. at 240 sites in 40 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 12 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 17 May 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 240 sites in United States, Brazil, Japan, France, United Kingdom and 35 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 17 May 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Radiographic Progression-free Survival (rPFS) (time frame: Baseline until radiographic disease progression or death, whichever occurred first (approximately up to 4.7 years)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01193244, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 May 2017.